Terminology

On analysing the interviews, it was clear that the terminology others used to describe their experience had a lasting effect on many of the participants.

Noting my own context of encountering hidden miscarriage and (attempted) abortion within my family, I must confess that it had never occurred to me to align miscarriage and abortion within this research. However, this issue was something that was raised during the interviews by the women who found references to miscarriage as (spontaneous) abortion very hurtful. As women raised this, it deserves to be shared so that others might hear how the

description of miscarriage as abortion (common within a medical context) can have a lasting effect on people’s lives.

I was conscious that the topic of abortion had been mentioned several times during the interviews. This encouraged me to return to the data to determine if this was a recurring theme. This proved to be the case as nine participants (F1, F3, F4, F5, F6, F7, F8, F10, F11) had made mention of this issue.

The subject of abortion was mentioned in three different ways.

1. Anger and resentment of individuals choosing to terminate their pregnancy when the participant was unable to have a successful

pregnancy. It should be noted that this was one participant’s view (F1) who had seven miscarriages and went on to adopt children. In her

interview, she revealed that she was in hospital for some time while still pregnant and on the same ward, “girls were coming in there and having abortions and going home and I was sitting watching ... all this

happening.” F1 added, “You are not doing what the rest are doing and trying to get rid of ...”

2. Those participants, two thirds of the interviewees, who required a medical intervention following the discovery that their baby had died in the womb. This was the case with F3, F4, F5, F6, F7, F8, F10 & F11. They spoke in terms of the references made by medical professionals that the procedure they were undergoing was an abortion. This caused hurt and anger as this was not a choice that the participants had made. The procedures may well be the same, but a change in terminology would be very supportive to grieving individuals.

F3 spoke about abortion after the tape was switched off. In my field notes, I noted that she hated the phrase, “spontaneous abortion” and much prefers the term miscarriage. She also discovered that her General Practitioner had used the word abortion in her notes. The word

‘spontaneous’ was missing and this she found very hurtful and upsetting.

Another issue that was raised was that a work colleague had an abortion at about the same time and who was able to return to work earlier than F3. This I noted to be significant. In essence it was the same procedure, but one was an elective abortion and the other non-elective. Both lost their babies but in the case of F3 it was a longed-for baby. Hence the use of the term ‘longed-for’ in the introduction to this thesis.

Similarly, F4 raised the issue of abortion. She had been taken into a ward to, “get cleaned out” as she described it. A routine scan had identified that her baby was dead. On admission to a ward, she realised others were there to have what was described as an ‘elective abortion’, and that the

staff used the word abortion freely. This she found to be very unsupportive.

F5, a nurse by profession, who had seven miscarriages had strong views on terminology. She said, “I would have hated for them to say, you know, either abortion, termination or anything else because automatically when you hear that you think that’s somebody’s choice.”

F7 miscarried at home and subsequently fell pregnant very quickly even although she had a birth control device fitted. When she went to the hospital, she was offered a termination, which she described as something that horrified her.

When arranging to interview F8, she spoke to me about her miscarriage between her two children. She was taken into a maternity ward and was surrounded by new mums. I quote, “I was asked ‘What did you have?’” In response, she spoke these words to me, “I had an abortion because that’s what it was – not that I was wanting one.” F8 went on to add that nobody came and said “sorry”. She got no comfort and mentioned that

miscarriage is taboo.

In the case of F9, she did not see her miscarriage (hospital induced) to be as harrowing (her word) as that of those who had an abortion. Her

miscarriage happened, she didn’t have a choice to make and so was very matter of fact in saying that she had it and moved on.

On reviewing my notes concerning F10, I noticed that she had strong views about the phrases ‘products of conception’ and ‘abortion’. This had struck me as interesting as F10 had been very pragmatic and spoke in terms of a loss of cells rather than a baby. There was a contradiction on the

recording as she had commented that on her medical notes there was no mention of a baby, only products of conception. This had been a point of annoyance for her as was the term abortion. F10 focussed on voluntary

abortion where people chose, “to get rid of baby when others were desperately wanting one.”

F11 was of the opinion that the term miscarriage was much more gentle.

Other phrases she found to be very unsupportive. Indeed, when a young hospital doctor used the term ‘products of conception’ and went on to say, “This lady has had an abortion”, it left her feeling guilty as if she had a choice in the matter.

3. One participant mentioned that some people refer to their abortions as miscarriages. It would be speculation to give a reason for this. However, F6 as a secondary school teacher involved in guidance referred to pupils being out of school ostensibly due to miscarriage when, in fact, it was an elective abortion. She spoke of the term miscarriage being used

“erroneously” and that some people use this word as, “their get-out clause” to hide the fact that they had an abortion. In her view she

believed that others, on hearing of her miscarriage, would talk about her behind her back that in actuality it was an abortion. She goes on to say,

a’ve seen and witnessed em ... a lot of pregnancies, em ... in young teenagers, em ... some of which, have ended ... by miscarriage, and from rumours, some of them are not, but

‘you know’ ... we’re not here to judge it not ... its em ... and some of them will be miscarriages, but they get gossiped about anyway.

This led F6 to speculate that her miscarriage would be viewed as an abortion by others.

It is clear to me that a change in terminology around early miscarriage could be an extremely supportive move in itself. It can be argued that while this is more situated within the medical and nursing domain, descriptions and phrases have had a lasting effect on the women who participated in my study. There is no easy answer, but greater consideration needs to be given to holistic care as recommended by WHO, so that each individual is responded to in a way that

they would find supportive. Regardless of the intent behind certain terminology, words like abortion and products of conception can have a lasting (and negative) response for those who have lost a longed-for baby.